Bakar Rabia Zehra, Köroğlu Nadiye, Turkgeldi Lale S, Tola Esra N, Cetin Berna Aslan, Gedikbasi Ali
Department of Obstetrics and Gynecology, Erbaa State Hospital, Tokat, Turkey.
Department of Obstetrics and Gynecology, University of Health Sciences, Kanuni Sultan Suleyman Training and Research Hospital, Istanbul, Turkey.
Arch Med Sci. 2019 Jul 11;17(3):694-699. doi: 10.5114/aoms.2019.86191. eCollection 2021.
Chorioamnionitis is one of the most important maternal complications in the expectant management of patients with preterm premature rupture of membranes (PPROM). Procalcitonin (proCT), the precursor of the hormone calcitonin, is used to differentiate bacterial infections from non-bacterial ones. The objective of the study was to determine the efficacy of maternal serum procalcitonin levels in the early prediction of chorioamnionitis in women with PPROM.
The study was conducted in 76 pregnant women hospitalized due to PPROM at the maternal-fetal medicine unit of a tertiary center in Istanbul. Patients were followed up with white blood cell (WBC), C-reactive protein (CRP) and proCT levels every 2 days. The values of investigated parameters were recorded at the diagnosis of PPROM and at the time of delivery. The maximum values during the follow-up period were also recorded.
Out of the 76 patients with PPROM, 15 (19.73%) developed clinical chorioamnionitis. No significant difference could be detected in the gravidity, parity, duration of hospitalization and gestational week at diagnosis between those patients who developed clinical chorioamnionitis and those who did not. The WBC at the time of hospital admittance and before delivery, and CRP levels before delivery were statistically higher in the chorioamnionitis group ( < 0.05). No difference in the proCT levels could be detected either at the time of hospital admittance or before delivery between the two groups.
Maternal proCT was not found to be predictive of chorioamnionitis. However, since there are reports in the literature that contradict these results, further studies are warranted to determine the true efficacy of proCT in the prediction of clinical chorioamnionitis.
绒毛膜羊膜炎是胎膜早破（PPROM）患者期待治疗中最重要的母体并发症之一。降钙素原（proCT）是激素降钙素的前体，用于区分细菌感染和非细菌感染。本研究的目的是确定母体血清降钙素原水平在PPROM女性绒毛膜羊膜炎早期预测中的有效性。
本研究在伊斯坦布尔一家三级中心的母胎医学科对76例因PPROM住院的孕妇进行。每2天对患者进行白细胞（WBC）、C反应蛋白（CRP）和proCT水平的随访。在PPROM诊断时和分娩时记录所研究参数的值。还记录随访期间的最大值。
76例PPROM患者中，15例（19.73%）发生临床绒毛膜羊膜炎。发生临床绒毛膜羊膜炎的患者与未发生者在妊娠次数、产次、住院时间和诊断时的孕周方面未检测到显著差异。绒毛膜羊膜炎组入院时和分娩前的白细胞以及分娩前的CRP水平在统计学上更高（<0.05）。两组在入院时或分娩前的proCT水平均未检测到差异。
未发现母体proCT可预测绒毛膜羊膜炎。然而，由于文献中有与这些结果相矛盾的报道，因此有必要进一步研究以确定proCT在临床绒毛膜羊膜炎预测中的真正有效性。
